Hyponatremia is a low sodium concentration in the blood.

It is generally defined as a sodium

concentration of less than 135 mmol/L (135 mEq/L), with severe hyponatremia being below
120 mEq/L. Hyponatremia is the most common type of electrolyte imbalance. It occurs in about
20% of those admitted to hospital and 10% of people during or after an endurance
sporting event.

Symptoms-Mild symptoms include-

 a decreased ability to think,

 dehydration,
 drwosiness,
 lethargy,
 confusion,
 reduced blood pressure,
 headaches,
 nausea,
 vomiting,
 fatigue,
 muscle cramp and poor balance.

Severe symptoms include confusion, seizures, and coma.

Causes-
The causes of hyponatremia are typically classified by a person's body fluid status into low
volume, normal volume, or high volume.

(1)Low volume hyponatremia can occur from diarrhea, vomiting, diuretics, and sweating.

(2)Normal volume hyponatremia is divided into cases with dilute urine

and concentrated urine.Cases in which the urine is dilute include adrenal
insufficiency, hypothyroidism, and drinking too much water or too much beer. Cases in which
the urine is concentrated include syndrome of inappropriate antidiuretic hormone
secretion (SIADH).

(3)High volume hyponatremia can occur from heart failure, liver failure, and kidney failure.
Conditions that can lead to falsely low sodium measurements include high blood protein
levels such as in multiple myeloma, high blood fat levels, and high blood sugar.

Hyponatremia Causes
There are a lot of reasons your sodium level might get too low. These include:
  Medications. Water pills (diuretics) and some antidepressants and pain medications increase
urination rate. That can affect our sodium level.
 Health problems. Heart failure and kidney or liver disease can affect the amount of fluids in
your body, and in turn, our level of sodium.
 Bouts of chronic, severe diarrhea or vomiting can deplete your body of fluids and sodium.
 Hormone imbalances. Some hormones affect your sodium levels. A condition called
SIADH (syndrome of inappropriate antidiuretic hormone) can make you retain water. And a
condition called Addison’s disease can affect the hormones that help keep our electrolytes in
check. If our thyroid hormone is too low, it can also affect your sodium level.
 Drinking too much water. It can dilute the amount of sodium in your blood. It usually
happens when people drink too much during endurance events like marathons or triathlons,
and also lose sodium through their sweat.

Mechanism: Low volume hyponatremia occurs when there is both water loss and
sodium loss, but the sodium loss exceeds the water loss. In other words, there is a
relatively larger loss of sodium compared to water.

Mechanism: Normal volume hyponatremia occurs when there is a water excess

without a proportional sodium gain. In other words, there is a relative dilution of
sodium due to water retention.